Skip to main content
Top
Published in: Strahlentherapie und Onkologie 6/2013

01-06-2013 | Original article

A validated scoring system to identify long-term survivors after radiotherapy for metastatic spinal cord compression

Authors: D. Rades, M.D., T. Veninga, A. Bajrovic, J.H. Karstens, S.E. Schild

Published in: Strahlentherapie und Onkologie | Issue 6/2013

Login to get access

Abstract

Purpose

This study aimed to develop and validate a scoring system to identify long-term survivors after conventional radiotherapy (RT) for metastatic spinal cord compression (MSCC).

Patients and methods

Data from 1,125 patients who had received long-course RT for MSCC were included in this study. Of these patients, 344 survived for over 12 months and 781 died within a year following RT. Based on differences between the distributions of patient characteristics in the two groups, a scoring system was developed. Scores ranged from 0 to 18 points and 15 points was selected as the cutoff for identifying long-term survivors. Data from the 1,125 long-course RT patients (test group) were compared to data from 773 patients receiving short-course RT (validation group).

Results

A score of ≥ 15 points was associated with a 94 % proportion of long-term survivors. The 15-point cutoff resulted in a specificity of 98 % and a positive predictive value of 94 % for identification of long-term surviving patients. The proportions of long-term survivors for each scoring point in the validation group were very similar to those in the test group.

Conclusion

This new scoring system enabled identification of long-term survivors after RT for MSCC with very high specificity and positive predictive value. The score proved to be valid and reproducible.
Literature
1.
go back to reference Amdur RJ, Bennett J, Olivier K et al (2009) A Prospective, Phase II study demonstrating the potential value and limitation of radiosurgery for spine metastases. Am J Clin Oncol 32:515–520PubMedCrossRef Amdur RJ, Bennett J, Olivier K et al (2009) A Prospective, Phase II study demonstrating the potential value and limitation of radiosurgery for spine metastases. Am J Clin Oncol 32:515–520PubMedCrossRef
2.
go back to reference Douglas S, Schild SE, Rades D (2012) Metastatic spinal cord compression in patients with cancer of unknown primary. Estimating the survival prognosis with a validated score. Strahlenther Onkol 188:1048–1051PubMedCrossRef Douglas S, Schild SE, Rades D (2012) Metastatic spinal cord compression in patients with cancer of unknown primary. Estimating the survival prognosis with a validated score. Strahlenther Onkol 188:1048–1051PubMedCrossRef
3.
go back to reference Garg AK, Shiu AS, Yang J et al (2012) Phase 1/2 trial of single-session stereotactic body radiotherapy for previously unirradiated spinal metastases. Cancer 118:5069–5077PubMedCrossRef Garg AK, Shiu AS, Yang J et al (2012) Phase 1/2 trial of single-session stereotactic body radiotherapy for previously unirradiated spinal metastases. Cancer 118:5069–5077PubMedCrossRef
4.
go back to reference Gerszten PC, Burton SA, Ozhasoglu C, Welch WC (2007) Radiosurgery for spinal metastases: clinical experience in 500 cases from a single institution. Spine 32:193–199PubMedCrossRef Gerszten PC, Burton SA, Ozhasoglu C, Welch WC (2007) Radiosurgery for spinal metastases: clinical experience in 500 cases from a single institution. Spine 32:193–199PubMedCrossRef
5.
go back to reference Gibbs IC, Kamnerdsupaphon P, Ryu MR et al (2007) Image-guided robotic radiosurgery for spinal metastases. Radiother Oncol 82:185–190PubMedCrossRef Gibbs IC, Kamnerdsupaphon P, Ryu MR et al (2007) Image-guided robotic radiosurgery for spinal metastases. Radiother Oncol 82:185–190PubMedCrossRef
6.
go back to reference Lutz S, Berk L, Chang E et al (2011) Palliative radiotherapy for bone metastases: an ASTRO evidence-based guideline. Int J Radiat Oncol Biol Phys 79:965–976PubMedCrossRef Lutz S, Berk L, Chang E et al (2011) Palliative radiotherapy for bone metastases: an ASTRO evidence-based guideline. Int J Radiat Oncol Biol Phys 79:965–976PubMedCrossRef
7.
go back to reference Martin AG, Cowley IR, Taylor BA et al (2012) (Stereotactic) radiosurgery XIX: spinal radiosurgery—2 year experience in a UK centre. Br J Neurosurg 26:53–58PubMedCrossRef Martin AG, Cowley IR, Taylor BA et al (2012) (Stereotactic) radiosurgery XIX: spinal radiosurgery—2 year experience in a UK centre. Br J Neurosurg 26:53–58PubMedCrossRef
8.
go back to reference Nelson JW, Yoo DS, Sampson JH et al (2009) Stereotactic body radiotherapy for lesions of the spine and paraspinal regions. Int J Radiat Oncol Biol Phys 73:1369–1375PubMedCrossRef Nelson JW, Yoo DS, Sampson JH et al (2009) Stereotactic body radiotherapy for lesions of the spine and paraspinal regions. Int J Radiat Oncol Biol Phys 73:1369–1375PubMedCrossRef
9.
go back to reference Patchell R, Tibbs PA, Regine WF et al (2005) Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 366:643–648PubMedCrossRef Patchell R, Tibbs PA, Regine WF et al (2005) Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 366:643–648PubMedCrossRef
10.
go back to reference Rades D, Douglas S, Veninga T et al (2010) Validation and simplification of a score predicting survival in patients irradiated for metastatic spinal cord compression. Cancer 116:3670–3673PubMedCrossRef Rades D, Douglas S, Veninga T et al (2010) Validation and simplification of a score predicting survival in patients irradiated for metastatic spinal cord compression. Cancer 116:3670–3673PubMedCrossRef
11.
go back to reference Rades D, Douglas S, Veninga T et al (2012) Metastatic spinal cord compression in non-small cell lung cancer patients. Prognostic factors in a series of 356 patients. Strahlenther Onkol 188:472–476PubMedCrossRef Rades D, Douglas S, Veninga T et al (2012) Metastatic spinal cord compression in non-small cell lung cancer patients. Prognostic factors in a series of 356 patients. Strahlenther Onkol 188:472–476PubMedCrossRef
12.
go back to reference Rades D, Fehlauer F, Schulte R et al (2006) Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression. J Clin Oncol 24:3388–3393PubMedCrossRef Rades D, Fehlauer F, Schulte R et al (2006) Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression. J Clin Oncol 24:3388–3393PubMedCrossRef
13.
go back to reference Rades D, Huttenlocher S, Bajrovic A et al (2011) Surgery followed by radiotherapy versus radiotherapy alone for metastatic spinal cord compression from unfavorable tumors. Int J Radiat Oncol Biol Phys 81:e861–e868PubMedCrossRef Rades D, Huttenlocher S, Bajrovic A et al (2011) Surgery followed by radiotherapy versus radiotherapy alone for metastatic spinal cord compression from unfavorable tumors. Int J Radiat Oncol Biol Phys 81:e861–e868PubMedCrossRef
14.
go back to reference Rades D, Huttenlocher S, Dunst J et al (2010) Matched pair analysis comparing surgery followed by radiotherapy and radiotherapy alone for metastatic spinal cord compression. J Clin Oncol 28:3597–3604PubMedCrossRef Rades D, Huttenlocher S, Dunst J et al (2010) Matched pair analysis comparing surgery followed by radiotherapy and radiotherapy alone for metastatic spinal cord compression. J Clin Oncol 28:3597–3604PubMedCrossRef
15.
go back to reference Rades D, Veninga T, Stalpers LJ et al (2007) Outcome after radiotherapy alone for metastatic spinal cord compression in patients with oligometastases. J Clin Oncol 25:50–56PubMedCrossRef Rades D, Veninga T, Stalpers LJ et al (2007) Outcome after radiotherapy alone for metastatic spinal cord compression in patients with oligometastases. J Clin Oncol 25:50–56PubMedCrossRef
16.
go back to reference Rose PS, Laufer I, Boland PJ et al (2009) Risk of fracture after single fraction image-guided intensity-modulated radiation therapy to spinal metastases. J Clin Oncol 27:5075–5079PubMedCrossRef Rose PS, Laufer I, Boland PJ et al (2009) Risk of fracture after single fraction image-guided intensity-modulated radiation therapy to spinal metastases. J Clin Oncol 27:5075–5079PubMedCrossRef
17.
go back to reference Ryu S, Jin R, Jin JY et al (2008) Pain control by image-guided radiosurgery for solitary spinal metastasis. J Pain Symptom Manage 35:292–298PubMedCrossRef Ryu S, Jin R, Jin JY et al (2008) Pain control by image-guided radiosurgery for solitary spinal metastasis. J Pain Symptom Manage 35:292–298PubMedCrossRef
18.
go back to reference Ryu S, Rock J, Jain R et al (2010) Radiosurgical decompression of metastatic epidural compression. Cancer 116:2250–2257PubMed Ryu S, Rock J, Jain R et al (2010) Radiosurgical decompression of metastatic epidural compression. Cancer 116:2250–2257PubMed
19.
go back to reference Tsai JT, Lin JW, Chiu WT, Chu WC (2009) Assessment of image-guided CyberKnife radiosurgery for metastatic spine tumors. J Neurooncol 94:119–127PubMedCrossRef Tsai JT, Lin JW, Chiu WT, Chu WC (2009) Assessment of image-guided CyberKnife radiosurgery for metastatic spine tumors. J Neurooncol 94:119–127PubMedCrossRef
Metadata
Title
A validated scoring system to identify long-term survivors after radiotherapy for metastatic spinal cord compression
Authors
D. Rades, M.D.
T. Veninga
A. Bajrovic
J.H. Karstens
S.E. Schild
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Strahlentherapie und Onkologie / Issue 6/2013
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-013-0342-1

Other articles of this Issue 6/2013

Strahlentherapie und Onkologie 6/2013 Go to the issue